PROJECT SUMMARY: Cognition in aging and neurodegenerative diseases reflects the net effect of multiple pathological, neuroplastic, and brain reserve processes. Penn's P30 Alzheimer's Disease Core Center (ADCC) is the foundation for many interactive clinical and basic research programs on AD and related disorders at Penn and beyond that investigate these processes. The Clinical Core's role is to support and promote this research to better characterize mechanisms of disease and resilience in patients and controls, to characterize the ways in which pathology clinically manifests in people over time, and to investigate ways to prevent or treat disease in order to maximize daily function and quality of life of older adults. The Clinical Core's base of operations is the Penn Memory Center (PMC), a multidepartmental clinical and clinical research outpatient center of the University of Pennsylvania Health System, where many of our research participants are recruited. We also have a longstanding research interest and commitment to an underserved Latino minority community through satellite recruitment in primary care practices in North Philadelphia and with the Education Core, we are expanding our outreach in the African American communities of West Philadelphia. The Clinical Core characterizes a longitudinal cohort of people with normal and abnormal brain aging who participate in our ADCC and its affiliated research programs by: a) applying standardized rating scales to measure past and current medical, cognitive, neurological, behavioral, and functional status, b) conducting and monitoring the clinical utility of neuroimaging studies and molecular-biochemical biomarkers for diagnosis, prognosis, and outcome c) establishing reliable and accurate consensus diagnosis, d) meticulously collecting and handling biospecimens, and e) recruiting and enrolling into affiliated research studies. The Clinical Core is the nexus for almost all of the clinical research conducted on AD and related disorders at Penn. It performs critical functions to support the mission of the Penn ADCC to increase the quality and quantity of AD-relevant research at Penn and beyond. Accordingly, it will continue to implement the following three aims: Aim 1: To identify, assess, and longitudinally evaluate patients from the earliest symptomatic stage of neurodegenerative dementia as well as individuals with normal cognition, gathering clinical data compliant with the National Alzheimer's Coordinating Center (NACC) Uniform Data Set (UDS), in addition to neuroimaging data, and biological material, including cerebrospinal fluid (CSF), blood, DNA and brain tissue. Aim 2: To facilitate the participation of individuals evaluated by the Clinical Core in collaborative research studies, including those of the Alzheimer's Disease Cooperative Study (ADCS) and the Alzheimer's Disease Neuroimaging Initiative (ADNI). Aim 3: To integrate the collection and management of data and biological samples with the other cores in a manner that facilitates collaborative studies and sample sharing among the ADCs and other qualified investigators.